personality disorders
Conditions
Interventions
All participants receive twice a week 45 minutes of TFP psychotherapy. The length of treatment can vary from 1 to 3 years. Sometimes medication is needed of additional time limited interventions (maxi
Sponsors
Arkin
Eligibility
Age
18 Years to 64 Years
Inclusion criteria
Inclusion criteria: In order to be eligible to participate in this study, a patient must meet all of the following criteria:meeting the criteria for at least one personality disorder as determined with the SCID-5-P as the main diagnosis;there has been at least one previous evidence based treatment aimed at the personality disorder from which the patient has not benefited (sufficiently) ; after assessment are eligible to start TFP treatment and willing to commit to scheduled TFP sessions twice a week for minimal one and maximum three years;18-64 years old;Speaks and reads fluently Dutch or English
Exclusion criteria
Exclusion criteria: A potential participant who meets any of the following criteria will be excluded from participation in this study:Presence of another serious psychiatric disorder that needs clinical attention first, such as a psychotic disorder, bipolar disorder type 1 or current severe addiction problems; Meeting three or more criteria of an antisocial personality disorder;Acute suicide risk that requires crisis care first;IQ < 80 (estimated on level of education); Serious medical or neurological conditions, such as dementia;Patients should not have any other form of psychological treatment during TFP except for time limited co-interventions targeting comorbidity like PTSD, substance abuse or severe relational problems (maximum 10 sessions).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| There are two primary outcome measures in the cohort study:First, the difference in the number of DSM 5 criteria for personality disorders that scored positive after 12 months of treatment compared to the baseline measurement. During the baseline measurement, the SCID-5-P interview will be used to determine whether the criteria for one or more personality disorders are met and how many criteria are met in total. After one year, it will be checked whether the research participant still meets the necessary criteria for a personality disorder (YES/NO) and dimensionally whether there is a change in the number of criteria that are met.Second, the WHO-DAS questionnaire will be administered at the baseline measurement and the subsequent follow-up measurements. This questionnaire maps the level of functioning and perceived limitations in six areas of life: cognition, mobility, self-care, interpersonal functioning, work and household roles, participation in society. The difference in score between the initial measurement and later measurements is the outcome measure.In the MBSCED part of the study, two questionnaires will be administered, both of which will be considered primary outcome measures. The LPFS-BF 2.0 (Level of personality functioning scale, brief form) is a short list of 12 items that measures personality functioning. The MHQoL (Mental Health Quality or LIfe) is a quality of life related to the mental health scale of 7 items. Both questionnaires will be administered monthly. The change in slope of the total scores of both lists during these assements are considered outcome measures.In the qualitative part of the study, a semi-structured interview will be conducted. This interview is partly based on existing questionnaires/interviews and partly newly developed in collaboration with the NPI client council. The aim of the interview is to map how TFP treatment is experienced in different stages of treatment and how participants view the concept of self-other di | — |
Secondary
| Measure | Time frame |
|---|---|
| There are several secondary outcome variables. The first is the slope of change in severity of impairments in personality functioning after one year, compared to baseline. In order to determine this change the LPFS-SR (Level of Personality Functioning Scale-self report, Morey ea, 2017) will be administered at predetermined measurement moments. The LPSF-SR is a valid and reliable self-report instrument that corresponds to the content of the DSM-5 criterion A of the alternative model of personality (Hopwood e.a.2018). It is translated in Dutch (LPFS-SR-NL, Rossi ea 2019) and contains 80 items. Respondents are asked to rate each item on a scale from 1 (completely untrue) to 4 (completely true). The LPSF-SR-NL contains the four subscales of the A criterion of the Alternative Model of Personality Disorders: identity, self-directedness, empathy and intimacy. Each of these subscales consists of 16 to 23 items. The scores on the subscales can be added together to determine a global index of the level of personality functioning, or in other words, to calculate an index that reflects the severity of the impairments in the core pathology of all personality disorders.The second is drop out during TFP treatment. Premature termination in psychotherapy occurs whenever a client begins an intervention, but then unilaterally terminates it against therapist recommendations and prior to recovering from the problems that led him or her to seek treatment in the first place (Swift & Greenberg, 2012).Drop out will be documented and reported (reason, number of days in treatment). It is allowed to finish treatment earlier than in the three year time frame, if both patient and treatment team agree that treatment has been successful and finishing treatment is justified. Such cases won’t count as treatment dropout. Next, the Structured Interview of Personality Organization (STIPO). The STIPO is a 100-item semi-structured interview that yields a dimensional assessme | — |
Countries
Netherlands
Contacts
Public Contacta noteboom
Arkin
Outcome results
None listed